Nursing home deaths spiked 32% among Medicare beneficiaries during 2020, OIG finds

More than 2 in 5 Medicare beneficiaries living in a nursing home were diagnosed or likely had COVID-19 during 2020, according to a new report from the Office of Inspector General (OIG).

Further, nursing homes saw nearly 170,000 more beneficiaries die during 2020 than in 2019, a roughly 22% increase in annual overall mortality, OIG wrote. In April 2020 alone, nearly 1,000 more beneficiaries died each day compared to the same month in 2019.

“The toll that the COVID pandemic has taken on Medicare beneficiaries in nursing homes demonstrates the need for increased action to mitigate the effects of the ongoing pandemic and to avert such tragedies from occurring in the future,” the office wrote in its report.

In its review (PDF) of Medicare claims from the 3.1 million beneficiaries living in nursing homes, OIG identified 762,594 beneficiaries with diagnostic test-confirmed COVID-19, and 532,901 were diagnosed as likely having the disease.

Cases in nursing homes grew exponentially during the spring, OIG wrote. Whereas 492 new Medicare beneficiaries were diagnosed as having or likely having COVID-19, new cases increased nearly tenfold to 4,700 per day in April.

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New cases lessened to roughly 4,000 per day during the summer but spiked at the tail end of the year with 6,679 new cases reported each day in December, OIG wrote.

“By the end of December, the total number of cases (1.3 million) was about 62 times more than it had been at the end of March,” OIG wrote.

Infection rates were similar across age groups and genders, with mortality also increasing across the board.

On the other hand, OIG found that Black (51%), Hispanic (49%) and Asian (47%) beneficiaries were each more likely than white (41%) beneficiaries to have COVID-19, according to the report. Year-over-year mortality increased for each of these groups, and the rate increased relatively less for white beneficiaries.

Deal-eligible beneficiaries living in nursing homes also shouldered a greater share of COVID-19 infections in 2020, with 56% having confirmed cases or suspected cases compared to 29% of Medicare-only beneficiaries, according to the report. Deaths also rose from 19% in 2019 to 26% in 2020 among this group versus an increase from 16% to 19% among Medicare-only beneficiaries.

OIG’s data come about a month after another report from the U.S. Government Accountability Office (GAO) that found most nursing homes were contending with multiple outbreaks between May 31, 2020, and Jan. 31, 2021. Outbreaks were often introduced by a member of the nursing home’s staff, GAO found, and very frequently lasted five or more weeks.